PubMed · 7718099
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K B Bruce. 1995. Join the LACTNET!. https://doi.org/10.1177/089033449501100115
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OBJECTIVE: Lactobacillus GG (L-GG), an acid- and bile-resistant strain that colonizes the intestinal mucosa, has been used to manage diarrhea in children. Our objective was to evaluate the prophylactic use of L-GG to prevent diarrhea in children at high risk from a developing country in a randomized, placebo-controlled trial. STUDY DESIGN: Two hundred four undernourished children 6 to 24 months old from an indigent peri-urban Peruvian town received either L-GG or placebo in flavored gelatin once daily, 6 days a week, for 15 months. Episodes of diarrhea were documented by daily home visits, and diagnostic studies were done in a subset of cases. Recovery of L-GG in stool from subjects and from family contacts was examined. RESULTS: Subjects in the L-GG group had significantly fewer episodes of diarrhea (5.21 episodes diarrhea/child/year ['ecy'] L-GG group, 6. 02 ecy placebo group; P =.028). The decreased incidence of diarrhea in the L-GG group was greatest in the 18- to 29-month age group (P =. 004) and was largely limited to nonbreastfed children (Breastfed: 6. 59 ecy L-GG, 6.32 ecy placebo, P =.7; Nonbreastfed: 4.69 ecy L-GG, 5. 86 ecy placebo, P =.005). The duration of diarrhea episodes and the causes of diarrhea were similar in both groups, except adenovirus was more common in the placebo group. CONCLUSION: L-GG supplementation may be useful as a prophylactic measure to control diarrhea in undernourished children at increased risk, especially nonbreastfed children in the toddler age group.
OBJECTIVE: Infants may have allergic disease even during exclusive breast-feeding. The aim of this study was to evaluate whether allergic infants should continue breast-feeding. STUDY DESIGN: We studied 100 infants who had atopic eczema during exclusive breast-feeding. The extent and severity of the eczema, allergic sensitization, and the patients' growth and nutrition were assessed during and after cessation of breast-feeding. RESULTS: The mean body length SD score decreased at the onset of allergic disease, and an association was seen between the duration of symptoms and poor growth (r = -.23, P =.04). Some improvement could be achieved by strict elimination diet by the mothers. The atopic eczema improved significantly after breast-feeding was stopped: SCORAD score 20 (range 15 to 27) during and 7 (range 4 to 11) after breast-feeding; t = 5.38, P <.0001, and the relative length of patients increased, in parallel with improved nutritional parameters. CONCLUSIONS: Breast-feeding should be promoted for primary prevention of allergy, but breast-fed infants with allergy should be treated by allergen avoidance, and in some cases breast-feeding should also be stopped. This particularly applies to infants with atopic eczema who also have impaired growth.